Noncompliance with Behavioral Recommendations Following Bariatric Surgery

Elkins, Gary; Whitfield, Paulette; Marcus, Joel; Symmonds, Richard E.; Rodríguez, Joaquín; Cook, Teresa

doi:10.1381/0960892053723385

Cited by 135 publications

(80 citation statements)

References 30 publications

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“…Não conseguimos identificar um padrão que diferenciasse os indivíduos que aderiram ao programa dos que desistiram, embora se observe no grupo dos aderentes uma tendência a ter um maior número de homens e níveis tensionais signi-ficativamente maiores. Esse achado é consistente com o achado de Elkins, que encontrou 41% de não aderência ao exercício no pós-operatório de cirurgia de obesidade (25), mas também não identificou fatores associados a esse comportamento. Em uma metanálise recente (26), evidenciou-se que a recomendação de exercícios não teve efeito sobre a hemoglobina glicosilada de diabé-ticos, mas todos os tipos de exercícios supervisionados foram eficazes, sendo tanto mais eficazes quanto maior o tempo empregado na prática.…”

Section: Discussionunclassified

Impacto de um programa mínimo de exercícios físicos supervisionados no risco cardiometabólico de pacientes com obesidade mórbida

Marcon

Gus

Neumann

2011

Arq Bras Endocrinol Metab

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OBJETIVO: Avaliar o impacto de um programa mínimo de exercícios físicos supervisionados na capacidade funcional e fatores de risco cardiometabólicos (FRCM) em obesos mórbidos. MATERIAL E MÉTODOS: Estudando uma série de casos com análise tipo pré e pós e amostragem por conveniência, avaliou-se o efeito de um programa semanal de 30 minutos de exercícios aeróbicos supervisionados, durante seis meses, no peso, na capacidade funcional e nos FRCM. RESULTADOS: Estudaram-se 61 indivíduos, dos quais 34 aderiram à intervenção. Nos aderentes, houve modificações em peso (-5,3 ± 5,3 kg, p < 0,0001), teste de caminhada de 6 minutos (69,8 ± 48,6 mts, p < 0,0001), pressão sistólica (-23,8 ± 27,7 mmHg, p < 0,0001), pressão diastólica (-14,4 ± 8,9 mmHg, p < 0 0001), escore de Framingham (-4,4 ± 5,1, p < 0,0001). CONCLUSÃO: Os resultados sugerem que exercícios físicos supervisionados em baixa intensidade e frequência podem interferir positivamente nos FRCM de indivíduos obesos mórbidos.

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Section: Discussionunclassified

Impacto de um programa mínimo de exercícios físicos supervisionados no risco cardiometabólico de pacientes com obesidade mórbida

Marcon

Gus

Neumann

2011

Arq Bras Endocrinol Metab

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“…In contrast, many public clinics and some private clinics have preoperative education and nutrition programs that require 6-12 months to complete, similar to presurgical behaviour modification recommendations in the literature. 33,34 From this perspective, an appropriate wait time for surgery could be in this range, which may not be out of reach for the public system with modest improvements. However, it should be noted that our wait time findings (median 21 mo, range 9-60 mo) are significantly less than those reported in recent studies of bariatric surgery in Canada (range 48-60 mo).…”

Section: Discussionmentioning

confidence: 99%

Comparison of public and private bariatric surgery services in Canada

Martín

Klemensberg²,

Klein³

et al. 2011

Can J Surg

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Background: Surgical treatment of obesity is cost-effective and improves life expectancy. Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB) are dominant surgical techniques, but RYGB is the only publicly insured procedure in all Canadian provinces. Private clinics currently offer AGB with minimal wait times. We sought to compare RYGB in public facilities with AGB in private clinics in terms of cost, wait times and certain aspects of patient care. Methods:We conducted telephone interviews of all bariatric surgery providers across Canada (100% response rate). We asked about various aspects of care, such as wait time, cost, pre-and postoperative care and surgeon experience. Results:The median out-of-pocket cost for AGB at private facilities is $16 000 (range $13 160-$18 375). Private clinics have much shorter wait times for AGB than public facilities do for RYGB (1 v. 21 mo, p < 0.001). Private clinics provide significantly fewer preoperative visits with multidisciplinary health professionals (2.7 v. 4.3, p = 0.045), and 5 of 12 (42%) private clinics conduct AGB surgeries without on-site critical care for high-risk (based on the respondents' definitions) patients. Conclusion:Private clinics performing AGB offer short wait times, but the cost is high. We found a great deal of variation between pre-and postoperative care among bariatric surgery facilities, and in some cases patient care appears to be less comprehensive. Our findings suggest that further research on obesity treatment is needed to inform policy so that all Canadians can have equitable and timely access to proven, evidence-based care.Contexte : Le coût du traitement chirurgical de l'obésité présente un bon rapport coût-efficacité et améliore l'espérance de vie. Le pontage gastrique Roux-en-Y (PGRY) et l'anneau gastrique ajustable (AGA) constituent les principales techniques chirurgicales, mais le PGRY est la seule intervention assurée par le secteur public dans toutes les provinces du Canada. Les cliniques privées offrent actuellement l'AGA après un temps d'attente minimal. Nous avons cherché à comparer la technique PGRY pratiquée dans des établissements publics à celle de l'AGA pratiquée dans des cliniques privées pour ce qui est des coûts, des temps d'attente et de certains aspects du soin des patients.Méthodes : Nous avons réalisé des entrevues téléphoniques auprès de tous les fournisseurs de services de chirurgie bariatrique au Canada (taux de réponse de 100 %). Nous avons posé des questions sur divers aspects des soins comme les temps d'attente, le coût, les soins préopératoires et postopératoires, et l'expérience du chirurgien.Résultats : Le coût direct médian de l'AGA dans les établissements privés s'établit à 16 000 $ (intervalle de 13 160 $ à 18 375 $). Les cliniques privées affichent des temps d'attente beaucoup plus courts pour l'AGA que les établissements publics dans le cas du PGRY (1 c. 21 mois, p < 0,001). Les cliniques privées fournissent un nombre significativement moins élevé de consultations préopératoires avec des ...

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“…12 Reasons for variation in the percent of excess weight loss (EWL) experienced by individuals depends on such variables as preoperative weight, age, gender, socioeconomic status, follow-up compliance, postsurgery physical activity, possible biochemical changes in the gut, and food choices of the individual. [13][14][15][16] Many studies show that, in most cases of recidivism, weight loss failure is due to dietary noncompliance or an inability to change eating, social, and exercise behaviors. [17][18][19][20][21][22] Following WLS, individuals must learn to cope with internal and external eating behavior stimuli, including the family environment, food availability, and emotional stress that may lead to weight regain.…”

Section: Introductionmentioning

confidence: 99%

Understanding Eating and Exercise Behaviors in Post Roux-en-Y Gastric Bypass Patients: A Quantitative and Qualitative Study

Benson-Davies¹,

Davies²,

Kattelmann

2013

Bariatric Surgical Practice and Patient Care

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Background: Weight regain following gastric bypass (GB) surgery continues to plague many individuals across the United States. However, understanding long-term eating and exercise behaviors to promote and sustain a lower weight following GB surgery is limited. Method: The purpose of this study was to explore the perceptions and attitudes of eating and exercise behaviors associated with weight maintenance in post-GB patients (n = 24) 2 or more years postsurgery. Demographic, anthropometric, and food record data were collected. Focus groups and personal interviews were used to understand behaviors and support systems associated with weight stabilization. Focus groups were audiotaped, transcribed, and organized into common themes. Results: All participants were female, with a mean of 6 years postsurgery, and had a mean age of 51.8 -10.5 years. The majority were married (71%) and had a college degree (58%). Although the average weight regain postsurgery was estimated at 16.2 -12.7 kg, most of the women (75%) had maintained a significant weight loss of at least 50% of their excess body weight. Themes associated with weight regain emerging from the focus groups included variable family support and a return to ''old eating habits.'' Conclusion: Focus group participants identified lack of long-term emotional support from family members and limited community support for weight loss surgery patients.

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Noncompliance with Behavioral Recommendations Following Bariatric Surgery

Cited by 135 publications

References 30 publications

Impacto de um programa mínimo de exercícios físicos supervisionados no risco cardiometabólico de pacientes com obesidade mórbida

Impacto de um programa mínimo de exercícios físicos supervisionados no risco cardiometabólico de pacientes com obesidade mórbida

Comparison of public and private bariatric surgery services in Canada

Understanding Eating and Exercise Behaviors in Post Roux-en-Y Gastric Bypass Patients: A Quantitative and Qualitative Study

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